Three preparatory studies for promoting implementation of outpatient schema therapy for borderline personality disorder in general mental health care

ObjectiveThree studies were conducted to prepare for the implementation of Schema Therapy (ST) for Borderline Personality Disorder (BPD) in general mental healthcare settings. Two were surveys to detect promoting and hindering factors, one was a preliminary test of a training program in ST.MethodsIn 2004, a diagnostic analysis of factors promoting and hindering implementation of a new treatment for BPD was conducted among both managers (n = 23) and therapists (n = 49) of 29 Dutch mental healthcare institutes through a written survey (Study 1). Next, a training program, including a set of DVDs displaying the major therapeutic techniques, was developed and tested among eight therapists. The training program was evaluated by the participants. After the training, three independent raters evaluated therapists' adherence and competence, viewing videos of the therapists completing structured role-plays (Study 2). In 2008, a second written survey was conducted in 22 mental health institutes to study factors for future nationwide implementation of ST (Study 3).ResultsBoth surveys indicated that the situation in most institutes was favorable for implementing a new effective treatment, as participants were not satisfied with the existing treatments, had suitable professional backgrounds, worked in settings with (B)PD-oriented care programs, and expressed a need for change. The surveys yielded clear results for promoting or hindering successful implementation of ST. Promoting factors included scientific evidence for the effectiveness of the treatment, structural changes in the patient's personality, rapidly noticeable effects for the patient, low drop-out rates and a favorable cost-effectiveness. Possible barriers included implementation mandated unilaterally by management, choosing ST based on financial or organizational needs, extending implementation over a lengthy period of time and providing telephone support by therapists beyond office hours. The eight-day training program received very positive ratings. After the training, therapists were rated as sufficiently adherent and competent applying ST to treat BPD patients, with peer supervision and supervision recommended as a supplement to the training.ConclusionThis study showed that the situation in 2005 was advantageous to start implementation of ST. Evaluation of the training and the achieved competence scores of trainees concluded that the training program was a good basis for training therapists in ST. Outcome of the survey in 2008 demonstrated that there was a clear interest for implementation of ST for BPD patients in the future.     

The relation of knowledge organization to performance of a complex cognitive task

The relationship between organization of knowledge in memory and level of proficiency in the performance of a complex cognitive task was evaluated. Based on their performance in a scenario, 42 Electronic Warfare (EW) technicians were categorized into 3 performance levels. To measure the organization of knowledge, the EWs rated all possible pairs of 24 concepts on degree of relatedness, and a Pathfinder net was created for each subject and for 2 expert EWs. A correlation of 0.40 between performance scores and a concept similarity measure indicates a significant positive association between level of proficiency and knowledge organization. Both high and intermediate performance groups produced nets that were more similar to the expert net than were those of the low performance group. © 1998 John Wiley & Sons, Ltd.     

Human non-visual discrimination of gradual turning is poor

We report three measures of the ability of normally sighted adults to discriminate turning while walking blindfolded outdoors. Constant error in selecting line drawings of paths indicated that participants under represent the amount of turning along more curved paths and over represent the amount of turning on less curved paths. Constant error in the direction of pointing to the origin of paths indicated a bias consistent with the direction of turning along more curved paths. Participants produced more accurate drawings of paths as the amount of turning increased. The results suggest that non-visual cues that accompany self movement are not sufficient for accurate representation of large radius curves in geographic scale travel.     

Beliefs in Equality for Women and Men as Related to Economic Factors in Central and Eastern Europe and the United States

Do economic indicators predict the general level of support for gender equality? This question was investigated in a sample of countries in Central and Eastern Europe, a region that has been undergoing rapid economic changes since the early 1990s. In this overall sample of male and female college students from ten countries, including the United States as a comparison, the predicted association between stronger beliefs in gender role egalitarianism and positive economic factors was generally supported. Also, consistent with other research, women were more in support of gender equality than men were. There was no support for a predicted trend in less support for gender equality over the time period of the present study.     

Relationships between personal values and reported behavior on ethical scenarios for law students

Lawyers' values might be considered to play some role in the decisions that are made in everyday legal practice. This study aimed to explore the effects of personal value hierarchies on ethical decision making within the context of several ethical dilemmas. A questionnaire was administered utilizing hypothetical situations presented in 11 ethical scenarios and including the Rokeach Value Survey. Logistic regression results suggested that different personal values were significant predictors of reported behavioral choices on respective ethical scenarios. However, the most important values associated with behavior consistent with ethical conduct in scenarios were 'honesty' and 'equality'. The implications of results are discussed in the contexts of ethics education in a tertiary educational environment and in relation to regulation for the professions.     

High school students’ suggestions for supporting younger pupils counteract cyberbullying

This study's aim was to explore high school students’ suggestions for supporting younger pupils prevent and deal with cyberbullying. Seventy-eight high school students participated in 11 focus groups, and had many concrete suggestions for ways they could support younger pupils against cyberbullying. The suggestions covered a range of activities, for instance advising younger pupils on how to avoid becoming victims of cyberbullying by teaching them netiquette. Furthermore, the students were positive toward involving adults in counteracting cyberbullying among younger pupils, for example educating younger pupils’ parents about cyberbullying. Moreover, the students suggested that they could show support for victims of cyberbullying by taking on the role of a friend when a younger pupil is cyberbullied and spend time with her/him during breaks. They also had ideas about supporting younger pupils in getting cyberbullies to stop, for instance by teaching the younger pupils technical skills for dealing with the cyberbullying on the Internet. To conclude, the findings in this study indicate that high school students want to be involved in supporting younger pupils against cyberbullying, and have many concrete suggestions for how this can be done. These findings have implications for counteracting cyberbullying in schools.     

Negative priming and sequence learning

Three experiments used a novel sequence learning task, in which participants responded to changes in location of one visual stimulus whilst ignoring another. Experiment 1 demonstrated negative priming effects in this task, in that responses to individual sequence elements were disrupted when the attended stimulus (e.g., red asterisk) appeared at the location taken by the unattended stimulus (e.g., blue asterisk) on the immediately preceding trial. Experiments 2 and 3 found that negative priming effects extended beyond sensitivity to individual items, suggesting that people may be able to learn about sequential features of ignored events as well as about single events in isolation. The results are discussed in relation to current theories of negative priming.     

The Effect of Movement Amplitude and Target Diameter on Reaction Time

Siegel’s (1977) interpretation that his reaction time results were solely a function of response factors (movement amplitude and target diameter) was discussed and criticized. It was argued that Siegel’s interpretation was inappropriate because stimulus factors (eccentric and visual angle) and response factors were confounded. It was also argued that the surprising U-shaped relation between reaction time and movement amplitude was probably the result of the confounding between stimulus and response factors.     

Towards the DSM‐5 Criteria for Autism: Clinical,Cultural, and Research Implications

The new edition of the DSM is proposing significant changes to current diagnostic definitions of autism and related conditions. In this article, we will discuss the clinical, research, and cultural implications of these changes. We conclude that the new criteria appear to better reflect current understanding of the autism spectrum disorder than the current DSM‐IV criteria. As expected with any major change in classification systems, there are also significant risks, which will have to be carefully monitored and addressed by both policy makers and the scientific community to ensure that best clinical practice and research are facilitated and advanced.